The 20 point gender gap in the 2012 election was the largest since Gallup poll began tracking in 1952 — the Obama-Biden ticket beat the Romney-Ryan ticket by a large margin with women, driven largely by women of color turning out at high rates for the President.

That loss was predictable based on polling that asked women questions about specific proposals in Paul Ryan’s previous budgets, which showed that women highly disapprove of cutting Medicaid, Medicare, and other vital programs that meet their health care needs. But the budget Ryan released this week suggests he learned nothing from women’s responses at the voting booth.

Ryan has never been a friend to women’s health, and has repeatedly taken action to limit women’s rights and access to health care — and his new budget is just more of the same. It would dismantle the advancements made through the Affordable Care Act and institute dramatic reductions in the services available through key programs, on top of the cuts women’s health services are already facing as a result of the sequester.

Here are the top four ways the new Ryan Budget (which is just the same as the old Ryan budget) guts key programs for women’s health:

Millions of women would lose the consumer protections and access to affordable health coverage that they gained under the health law. These reforms are critical for both women’s health and economic security.

The Ryan budget would eliminate the ban on discrimination against those with preexisting conditions, including breast cancer, Cesarean sections, rape, and health needs related to domestic violence; provisions that allow young women to stay on their parents health insurance plans until age 26; premium tax credits that help individuals and small businesses purchase health insurance; Obamacare’s expansion of Medicaid; and a slew of other benefits that the law provides for women’s health.

By repealing protections in Obamacare, the Ryan budget would preserve an individual health insurance market that routinely discriminates against women. Insurance companies in the individual market charge women $1 billion more in premiums than men each year for the same set of benefits. Under the health reform law, insurers will also be required to cover maternity care — only 12 percent of plans on the individual market currently do.

Women are 70 percent of adult Medicaid beneficiaries. In fact, more than one in ten non-elderly women receive their health insurance coverage through Medicaid.

But the Ryan budget would replace guaranteed federal funding for Medicaid with block grants to states — fixed sums of money set in advance, regardless of actual costs. By 2023, the Ryan budget would reduce federal Medicaid spending by 810 billion, forcing states to cut back on coverage and benefits. And by repealing Obamacare’s Medicaid expansion, the Ryan budget would deny Medicaid coverage to at least 7 million women who are expected to become newly eligible for the program if the law is fully implemented, leaving them with nowhere to turn for coverage.

Women represent over half of Medicare beneficiaries and 62 percent of those over the age of 80.

The Ryan budget would move toward a privatization of Medicare, proposing that those currently in the health program get vouchers for private insurance. Under the Ryan plan, the first seniors hit by these changes could pay up to $59,500 more during retirement, with those who will be Medicare eligible in 2050 paying up to $331,200 more.

Women on Medicare generally earn less in social security benefits than their male counterparts and have higher out-of pocket-medical costs. Paul Ryan’s plan to privatize Medicare threatens both the health and economic security of elderly women.

4. Attacks reproductive health and family planning.

By repealing Obamacare and gutting Medicaid, the Ryan budget would severely undermine access to reproductive health care, especially contraception, for millions of women.

47 million women are projected to benefit from the no-cost preventive services that have already gone into effect, including mammograms, Pap smears, well-baby care, contraception, preconception and prenatal care in well-woman visits, gestational diabetes screening, lactation supports, and much more. In addition, the Medicaid program provides 75 percent of public funding for family-planning services and is expected to play an even greater role in providing access to family planning once the ACA is fully implemented.

Women of reproductive age spend 68 percent more on their health care expenses than men and their reproductive health care and the expense of birth control is a significant part of that spending. Surveys show that nearly one in four women with household incomes of less than $75,000 have put off a doctor’s visit for birth control to save money. More than half of young adult women say they have not used their prescribed contraceptive method as directed because it was cost-prohibitive.

Our guest blogger is Lindsay Rosenthal, a Research Assistant for Health Policy and Women’s Health and Rights at the Center for American Progress.

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